不同类型灭菌器对葡萄糖稳定性的影响

通过抽查我院药检室按中国药典规定方法测定１９９７年１０％ＧＳ、５％ＧＳ、５％ＧＮＳ的原始记录，对１０％ＧＳ、５％ＧＳ、５％ＧＮＳ在不同类型灭菌器灭菌后的５－ＨＭＦ值Ａ列表对比及５％ＧＳ、５％ＧＮＳ在不同类型灭菌器灭菌前后的ＰＨ△ＰＨ列表对比。结果：１０％ＧＳ、５％ＧＳ、５％ＧＮＳ用快速冷却灭菌器灭菌与用卧式矩形压力蒸汽消毒器灭菌使葡萄糖分解成５－ＨＭＦ值Ａ差异非常显著，５％ＧＳ、５％ＧＮＳ用卧式矩     

小儿难治性肾病110例临床病理及疗效分析

１１０例难治性肾病中，单纯性肾病７７例（７０％），肾炎性肾病３３例（３０％）。病理类型，ＭｓＰＧＮ，４４．５％，ＩｇＭＮ２０．９％，ＩｇＡＮ１１．８％，Ｃ１ｑ肾病０．９％，以系膜增生改变占大多数，共７８．１％，ＭＣＤ６．４％，ＭＬ４．５％，ＥｎＰ２．７％，ＣｒＧＮ２．７％，ＦｓＧＳ，ＭＰＧＮ，ＦＰ各１．８％，病理类型轻的ＭＣＤ，ＭＬ仅见于单纯性肾病，轻度ＭｓＰＧＮ，ＩｇＭＮ以单纯性肾病多见，病理类     

溴隐亭治疗肢端肥大症继发糖尿病与糖耐量异常报告

１９８３－１９９３年６月收治肢端肥大症２８例中，糖耐量异常５例占１８．５％，糖尿病１１例占３９．２８％，采用溴隐亭治疗５例ＩＧＴ恢复正常，３例无临床症状，ＦＢＳ８．８－１５ｍｍｏｌ／Ｌ治疗一月后ＦＢＳ降至正常，４例有临床症状ＦＳ１５－１６ｍｍｏｌ／Ｌ，仅用溴隐亭７．５－１５ｍｇ／日治疗，ＦＢＳ除１例外均正常。４例ＦＢＳ１２．０４６－４９．２３７ｍｍｏｌ／Ｌ，尿糖＋＋－＋＋＋，采用饮食控制并加用胰岛     

163例学龄前后儿童血清SF含量调查分析

目的：调查学龄前、后儿童血清铁蛋白（ＳＦ）含量状况，以便能诊断早期缺铁性贫血，使其及早得以治疗，从而促进儿童的正常发育。方法：采用放射免疫分析技术（ＲＩＡ），将１６３例学龄前、后（包括幼儿园和小学１－５年级学生）儿童按所处环境分为市区组和郊县组进行血清ＳＦ测定。结果：调查发现市区组儿童血清ＳＦ含量明显低于郊县组儿童（低１３．６６％）；在１６３例中有１９例血清Ｔ值＜１４ｎｇ／ｍｌ（占１１．６６％），且市区组中有１１例ＳＦ值＜１２ｎｇ／ｍｌ，而其它贫血指标均正常的隐性贫血患儿（占６．７５％）。不同年龄血清ＳＦ含量无明显差异（Ｐ＞０．０５）。另外，有１０％的儿童血缘基本正常，但其ＳＦ值均＜１２ｎｇ／ｍｌ，经服用铁剂后１个月复查，血清ＳＦ值均＞１４ ｎｇ／ｍｌ。结论：调查学龄前、后儿童血清ＳＦ含量状况，对早期诊断缺铁性贫血或隐性贫血及观察服用铁剂治疗效果，进而促进儿童的正常发育是很有必要的。     

大肠杆菌分泌型载体表达重组人碱性成纤维细胞生长因子

设计构建了带有大肠杆菌外膜蛋白信号肽序列的重组分泌型表达载体ｐＳＥ－ｈｂＦＧＦ，在大肠杆菌ＤＨ５α中分泌表达了重组人碱性成纤维细胞生长因子。ＳＤＳ－ＰＡＧＥ、免疫印迹及生物活性测定均表明表达产物分泌到细胞细菌周质和培养式中。分泌到周质中的ｒｈｂＦＧＦ可占周质总蛋白的１５％。     

163例学龄前后儿童血清SF含量调查分析

目的：调查学龄前、后儿童血清铁蛋白（ＳＦ）含量状况，以便能诊断早期缺铁性贫血，使其及早得以治疗，从而促进儿童的正常发育。方法：采用放射免疫分析技术（ＲＩＡ），将１６３例学龄前、后（包括幼儿园和小学１～５年级学生）儿童按所处环境分为市区组和郊县组进行血清ＳＦ测定。结果：调查发现市区组儿童血清ＳＦ含量明显低于郊县组儿童（低１３．６６％）；在１６３例中有１９例血清ＳＦ值〈１４ｎｇ／ｍｌ（占１１．６６％），且市区组中有１１例ＳＦ值〈１２ｎｇ／ｍｌ，而其它贫血指标均正常的隐性贫血患儿（占６．７５％）。不同年龄血清ＳＦ含量无明显差异（Ｐ〉０．０５）。另外，有１０％的儿童血缘基本正常，但其ＳＦ值均〈１２ｎｇ／ｍｌ，经服用铁剂后１个月复查，血清ＳＦ值均〉１４ｎｇ／ｍｌ。结论：调查学龄前、后儿童血清ＳＦ含量状况，对早期诊断缺铁性     

Inhibitory effect of antisense basic fibroblast growth factor oligonucleotides on proliferation of cultured aortic smooth muscle cells induced by angiotensin Ⅱ in SHR rats

目的：研究转染反义碱性成纤维细胞生长因子（ｂＦＧＦ）寡核苷酸（ＯＤＮ）对培养的自发性高血压大鼠（ＳＨＲ）主动脉平滑肌细胞（ＳＭＣ）生长的影响．方法：用脂质体介导法将反义ｂＦＧＦＯＤＮ转入ＳＭＣ内，用Ｎｏｒｔｈｅｒｎ杂交检测ｂＦＧＦ基因表达，并测定［３Ｈ］ｔｈｙｍｉｄｉｎｅ掺入和细胞计数．结果：转染反义ｂＦＧＦＯＤＮ（５μｍｏｌ·Ｌ－１）几乎完全抑制血管紧张素Ⅱ（ＡｎｇⅡ，１μｍｏｌ·Ｌ－１）诱导增高的ｂＦＧＦｍＲＮＡ表达和明显抑制ＳＭＣ增殖，在基础状态和ＡｎｇⅡ刺激条件下，［３Ｈ］ｔｈｙｍｉｄｉｎｅ掺入分别被抑制２６５％（Ｐ＜００１）和４２０％（Ｐ＜００１），细胞数分别被抑制１７３％（Ｐ＜００１）和２２２％（Ｐ＜００１）．结论：反义ｂＦＧＦＯＤＮ能有效抑制ＡｎｇⅡ诱导的ｂＦＧＦ基因表达和ＳＭＣ增殖．     

血清肿瘤特异性生长因子（TSGF）检测诊断肿瘤的应用：附112例检测报告

本文对２５例正常人和１１２例恶性肿瘤患者及部分治疗后患者血清中ＴＳＧＦ含量进行测定比较。结果表明：恶性肿瘤患者血清中ＴＳＧＦ含量明显升高，且治疗后含量和阳性率都明显下降。其对恶性肿瘤诊断的敏感性为７８．８％，特异性可达９６．０％，准确性为８３．５％。对恶性肿瘤的筛查诊断、疗效观察、病情监测和预后有极为重要的意义     

表皮生长因子对肿瘤敏感性和肾毒性的影响

为探讨外源性表皮生长因子在肿瘤治疗中的可能应用,小鼠接种肉瘤（Ｓ１８０）,于接种后第２,６天腹腔注射顺铂（ＣＤＤＰ）２ｍｇ／ｋｇ,在ＣＤＤＰ处理的同时０小时,前１２,前２４小时皮下注射ＥＧＦ５μｇ／只及前２４小时腹腔注射ＥＧＦ５μｇ／只;大鼠一次腹腔注射ＣＤＤＰ５ｍｇ／ｋｇ,于ＣＤＤＰ处理前２４小时皮下注射ＥＧＦ２０μｇ／只。结果显示ＥＧＦ腹腔及皮下处理均能促进Ｓ１８０生长;ＥＧＦ只有于ＣＤＤＰ前皮下处理才能增高Ｓ１８０对ＣＤＤＰ敏感性;ＥＧＦ增高敏感性的同时,小鼠去瘤体重及大鼠血清ＢＵＮ、Ｃｒ水平均与对照组无差别     

胃腺癌组织中血管内皮生长因子的表达与微血管密度的关系

为探讨胃癌组织中血管内皮生长因子（Ｖａｓｃｕｌａｒ ｅｎｄｏｔｈｅｌｉａｌ ｇｒｏｗｔｈ ｆａｃｔｏｒ ＶＥＧＦ）及微血管密度（Ｍｉｃｒｏｖｅｓｓｅｌ ｄｅｎｓｉｔｙ ＭＶＤ）的关系。本文应用免疫组化Ｓ－Ｐ法对４０例胃癌及２０例正常胃组织中ＶＥＧＦ及ＭＶＤ作了检测,结果表明：１．正常胃组织中ＶＥＧＦ表达全部阴性。胃癌组织中ＶＥＧＦ阳性表达率为６２．５％,ＶＥＧＦ的表达与细胞组织学分级及淋巴结转移有     

Effects of genetic polymorphisms of the renin-angiotensin system in children with nephrotic syndrome.

BACKGROUND: The renin-angiotensin system (RAS) has been considered to be responsible for the pathogenesis or progression of many diseases which may or may not be related to kidney. Genetic polymorphisms of the various components of the RAS have been associated with differences in the clinical course of several disease states in adults and children. OBJECTIVES: The purpose of our study was to investigate RAS gene polymorphisms in patients with steroid resistant primary focal segmental glomerulosclerosis (FSGS) and nephrotic syndrome responding to steroid therapy. Furthermore, we aimed to investigate whether there was an association between polymorphic alleles and responses to steroid therapy, the degree of renal dysfunction, and prevalence of end-stage renal disease (ESRD). MATERIAL AND METHODS: One hundred and fifty-eight children with the diagnosis of nephrotic syndrome were recruited from the Nephrology unit in the Department of Paediatrics of Ege University. Forty-nine of them were classified as renal biopsy-proven FSGS and 102 patients were considered to have response to steroid treatment. Renal functional impairment was detected in 19 subjects with FSGS and end-stage renal insufficiency in 13 patients. The control group consisted of 287 healthy adult subjects. Angiotensin-converting enzyme (ACE), angiotensin II type 1 receptor (AT1R) and angiotensinogen (AGT) gene polymorphisms were determined by the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) technique. Statistical significance was regarded as p<0.05. RESULTS: There were no statistically significant differences for the C allele of AT1R or the T allele of AGT genes between the children with nephrotic syndrome and control group, but on the other hand statistically significant differences were detected for D allele of ACE gene. There was no significant relationship detected between the D allele of ACE, the C allele of AT1R or the T allele of AGT genes and response to steroid therapy, extent of renal dysfunction and the progression to ESRD. However, there was a significant relationship between T allele of AGT gene and resistance to steroid treatment (OR; 4,837, 95% CI; 1,723-13,577, p=0.01), renal dysfunction (OR; 3,189, 95% CI; 0,999-10,182, p=0.041) and progression to ESRD (OR; 3,852, 95% CI; 1,057-14,040, p=0.03). CONCLUSION: In this study, the angiotensinogen -235T allele was found to be related with steroid resistance, renal dysfunction and progression of ESRD in nephrotic syndrome.     

Emerging therapeutic strategies for minimal change disease and focal and segmental glomerulosclerosis

ABSTRACT

Introduction: Minimal change disease (MCD) and Focal and segmental glomerulosclerosis (FSGS) are two of the major causes of nephrotic syndrome (NS) in children and adults. According to KDIGO (Kidney Disease: Improving Global Outcomes) guidelines, the treatment of adult primary MCD and FSGS should be based on immunosuppressants and antiproteinuric drugs. Recently, Rituximab, a humanized monoclonal antibody (mAb) has emerged as a potential treatment for steroid or calcineurin inhibitor-dependent patients; it has however demonstrated lower efficacy in those with nephrotic syndrome that is resistant to the above indicated drugs.

Area covered: Analysis of ongoing and already completed clinical trials, retrieved from clinicaltrials.gov, clinicaltrialsregister.eu and PubMed involving new therapies for nephrotic syndrome secondary to MCD and FSGS.

Expert opinion: The most promising drugs under investigation for MCD and FSGS are mAbs. We are hopeful that new therapeutic options to treat multi-drug resistant MCD and FSGS will emerge from currently ongoing studies. What appears certain is the difficulty in enrolling patients affected by orphan renal diseases and the selection of valid endpoints in clinical trials, such as kidney failure.     

试论IgA肾病临床表现与肾脏病理的关系

目的临床分析IgA肾病患者的临床表现及肾脏病理关系。方法选取我院2011年8月至2012年8月收治的200例肾穿刺活检患者,给予B超肾活检、免疫检查、光镜检查,分析确诊的IgA临床特点与病理。结果经过检查后得知,有70例患者确诊为IgA肾病,其中15例肾病综合征、2例肾小球肾炎、9例血尿、17例隐匿性肾小球肾炎、25例慢性肾小球肾炎、1例肾功能不全、1例妊娠伴随慢性肾炎。病理类型：12例轻微病变、15例系膜增殖型、25例局灶节段性硬化、9例FSGS型、5例增生硬化型。结论针对IgA肾病患者,其临床表现和病理表现之间的严重程度不完全相符,实施肾活检,可有有效判断肾脏疾病病理类型,有利于确定治疗方案,改善预后。     

儿童IgM肾病与肾病综合征

目的探讨儿童IgM肾病的临床、病理、治疗效果及预后。方法对6例IgM肾病患儿的临床资料、肾组织病理、治疗疗效及预后进行分析。结果①6例患儿均在光镜下见系膜细胞及系膜基质增生,免疫荧光镜见IgM或以IgM为主的免疫复合物在系膜区分枝状沉淀,电镜下见足突大部分融合,3例患儿伴有局灶节段硬化。②6例IgM肾病患儿,均符合肾病综合征的诊断标准,4例为单纯型肾病,对糖皮质激素治疗敏感,此3例患儿得到缓解,1例耐药的患儿,加用CTX和肝素后,尿蛋白持续转阴;2例为肾炎型肾病,对糖皮质激素治疗的反应,1例抗药,另1例部分敏感。结论①IgM肾病、微小病变、局灶节段肾小球硬化可能为同一疾病的不同方面或阶段。②临床表现、疗效及预后与肾组织病理尤其与小管-间质病变密切相关。③对表现为肾病综合征的患儿,在正规治疗的同时,即应避免高蛋白饮食及肥胖,对高脂血症给予有效治疗,并尽早使用血管紧张素抑制剂。     

A case of mesangial IgM nephropathy with decreased renal function

A case of mesangial IgM nephropathy associated with chronic renal failure is described. The patient did not reveal nephrotic syndrome during the clinical course. Renal biopsy specimens revealed typical features of mesangial IgM nephropathy when studied by light microscopy, electron microscopy and immunofluorescence staining. Mesangial IgM nephropathy is considered to be a heterogenous disorder, because this disorder is clinically characterized by nephrotic syndrome, mild proteinuria and/or hematuria or renal failure.     

环孢素A治疗小儿难治性肾病综合征疗效分析

目的观察环孢素A(CsA)治疗小儿难治性肾病综合征的疗效和不良反应。方法回顾分析31例使用CsA治疗的难治性肾病综合征患儿临床资料,其中激素耐药8例,激素依赖10例,频复发13例;微小病变(MCNS)19例,系膜增生性肾小球肾炎(MsPGN)9例,局灶节段性硬化(FsGS)3例。结果完全缓解19例(61.3%),部分缓解7例(22.6%),无效5例(16.1%)。不同临床类型中,激素依赖型完全缓解率最高(80%),激素耐药型完全缓解率最低(25%),2类型间比较差异有统计学意义(P<0.05)。不同病理类型中,微小病变型完全缓解率最高(68.4%),局灶节段性硬化完全缓解率最低(33.3%),2类型间比较差异有统计学意义(P<0.05)。CsA治疗过程未出现明显的肾毒性反应。结论 CsA治疗小儿难治性肾病综合征安全有效,注意监测血药浓度,肝肾功能情况下,CsA治疗未见严重不良反应。     

C1q nephropathy in a 2-year-old boy presenting with steroid resistant nephrotic syndrome

We experienced a case of a 2-year-old boy, who presented with steroid resistant nephrotic syndrome, which developed insidiously. Renal biopsy revealed that he had focal and segmental glomerulosclerosis on light microscopy, dominant mesangial deposition of C1q by immunofluorescent staining, and electron dense deposits on electron microscopy, which are all compatible with C1q nephropathy. He had no clinical sign of any collagen diseases, including systemic lupus erythematodes. So, the diagnosis of C1q nephropathy was made. An intensive treatment by a combination of cyclosporine, prednisolone and methylprednisolone pulse therapy was successful in achieving remission and disappearance of proteinuria in this patient. Although he developed hypertension requiring calcium blocker and angiotensin converting enzyme inhibitor, his renal function stayed within normal limit for 3 years after the initiation of the treatment. The growth was well preserved during the 3 years of treatment with almost unchanged SD scores for height. He has delay in speech, which may not be associated with the etiology of his nephropathy, based on the absence of such association in the previous reports. C1q nephropathy is still a controversial clinical entity, so accumulation of the cases may help further understand the pathogenesis and clinical manifestation of C1q nephropathy.     

环孢素三联疗法治疗小儿难治性肾病综合征

目的通过检测临床指标的变化,观察应用环孢素（CsA）联合中剂量强的松及地尔硫卓（CsA三联疗法）治疗小儿难治性肾病综合征的临床疗效。方法 2004年10月至2008年10月在河南省人民医院儿科住院的27例难治性肾病综合征患儿运用CsA三联疗法进行治疗。进行1年的随访,在治疗前、治疗后3、6、12个月分别记录24 h尿蛋白定量、尿NAG酶、肝功能（ALT）、肾功能（SCR）及环孢素血药浓度指标的变化,并记录不良反应。应用SPSS 17.0软件进行统计学分析。结果 27例接受CsA三联疗法治疗后20例（74.07%）患儿病情缓解,其中完全缓解14例（51.85%）,部分缓解6例（22.22%）,无效7例（25.93%）。22例患儿进行了肾穿刺活检,MCD 10例总缓解率为90.00%,MsPGN 9例总缓解率为77.78%,3例FSGS缓解1例。病例中23例出现毛发增多的现象,4例齿龈增生,2例出现血压增高现象,4例出现轻微的胃肠道反应,CsA治疗过程未出现明显肾毒性反应。结论应用环孢素三联疗法治疗小儿难治性NS,能明显提高CsA的疗效,减少CsA用量并降低CsA的不良反应,同时能促进肾功能的恢复,改善小儿难治性NS临床检测指标。     

46例成人肾病综合征临床与病理分析

目的探讨成人肾病综合征临床与病理分型特点,以及肾穿刺活检术在成人肾病综合征诊断中的意义。方法在B超或彩超引导下,应用半自动肾活检针单人操作行经皮肾穿刺活检术46例次,标本送福州总医院病理科行光镜、免疫组化及电镜等病理检查。结果46例肾病综合征按临床表现分单纯型15例、非单纯型31例,后者可再细分为血尿型12例,高血压型4例,肾炎综合征型7例和肾功能衰竭型8例。病理类型有：微小病变1例,系膜增生性肾小球肾炎11例,膜性肾病3例,局灶性节段性肾小球硬化3例,IgA肾病7例,增生硬化性肾小球肾炎1例,新月体肾炎1例,狼疮肾炎8例,乙肝相关性肾小球肾炎8例,糖尿病肾病1例,肾淀粉样变性1例,过敏性紫癜肾小球肾炎1例。结论肾病综合征临床表现差异性提示其病因、病理类型及严重程度不同,其治疗及预后也不同。肾穿刺活检对于成人肾病综合征的诊断、治疗和预后判断有重要的临床意义,如无禁忌证应积极开展此项检查以明确诊断。     

Relationship between lymphocyte and clinical steroid responsiveness in focal segmental glomerulosclerosis

A remission in nephrotic proteinuria with steroid treatment appears to favorably alter the natural history of focal segmental glomerulosclerosis (FSGS). It is not known why some patients have a favorable response to steroid treatment whereas others do not. Considering the possibility that differences in the pharmacodynamic responsiveness to steroids among patients might be one factor, the authors examined the relationship between the pretreatment suppressive effect of steroids on lymphocyte proliferation (% inhibition) in vitro and the short- and intermediate-term responses of creatinine clearance (Clcr) and/or nephrotic proteinuria (urine protein/creatinine ratio = Up/c) in 13 patients with FSGS. There were significant correlations between % inhibition and the changes in Clcr at 3 (r = 0.92, p < 0.001) and 6 (r = 0.86, p < 0.01) months and the changes in Up/c at 3 months (r = -0.74, p = 0.02). Thus, the greater the pretreatment lymphocyte steroid sensitivity, the greater the increase in Clcr or decrease in Up/c. The changes in these parameters could not be accounted for on the basis of steroid dose or histopathology. The in vitro sensitivity of FSGS patients' lymphocytes to steroids may be of value in anticipating their clinical response to treatment.